Discomfort in Upper Left Back and Sacral Region
At 29 years old, I have a history of myofascial pain, dating back to my college days. For approximately two weeks now, I have been experiencing persistent, dull discomfort that is not sharp but quite unsettling. I maintain an active lifestyle, engaging in reformer Pilates three times a week, strength training with a personal trainer twice a week, and swimming regularly. The pain occasionally alleviates with remedies such as Epsom salt baths and deep tissue massages, though it does not consistently respond to Advil. After a phone consultation last Friday, the doctor recommended a consult with a spine clinic and physical therapist, and prescribed meloxicam, which appears to be reducing the discomfort somewhat. However, I find myself increasingly anxious that this may be indicative of a more serious issue beyond mere muscle pain or spasms. How can I distinguish between pain originating from muscle versus that from bone? For peace of mind, I believe I should undergo imaging to eliminate any concerns, such as potential cancer. Would a CT scan be advisable? I would greatly appreciate any guidance you might offer. Thank you very much!
Answers (1)
8/6/2025, 9:31:05 PM
OpenHealth AI
It's understandable to feel anxious about persistent discomfort, especially when it disrupts your active lifestyle. The good news is that many cases of back pain, particularly where you describe dull discomfort, can often be attributed to muscle or myofascial issues rather than serious underlying conditions.
Explanation
Muscle pain often feels different than pain arising from bones or other tissues. Muscle pain is usually described as a dull ache or soreness, whereas bone pain might feel sharper or more localized and could worsen with movement. Given your active routine and the fact that you've experienced some relief from self-care measures like Epsom salt baths and massages, this further suggests that the issue may be muscular rather than related to bone or a serious condition.
Next Steps
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Continue Current Management: Since meloxicam has provided some relief, continue with this as directed. It's also beneficial to keep using Epsom salt baths and deep tissue massages regularly.
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Monitor Symptoms: Keep a brief daily log of your pain – noting when it worsens, what activities seem to trigger it, any associated symptoms (like weakness, numbness, or changes in bowel/bladder function), and the effectiveness of your remedies. This can help you and your healthcare provider assess trends over time.
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Physical Therapy: If you haven’t already, follow through with the recommendations for physical therapy. A physical therapist can provide targeted exercises and techniques to help alleviate pain and improve function.
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Consider Imaging with Caution: While discussing imaging like a CT scan with your healthcare provider is reasonable for peace of mind, remember that imaging is typically reserved for cases where there are red flags such as severe pain, significant weakness, or neurological symptoms. Since you don’t have any acute alarming symptoms, it may be considered only if there’s no improvement after conservative treatments.
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Emotional Support: Given your anxiety about the situation, consider practices like mindfulness, meditation, or breathing exercises to help manage stress related to your pain. Engaging in gentle activities like yoga, which complements your Pilates, can also be beneficial both physically and mentally.
It’s important to communicate your concerns about possible serious conditions to your healthcare team. They can help reassure you and decide if further action, including imaging, is necessary based on your symptoms and examination findings. Take care, and remember that many people manage similar discomfort successfully with proactive measures and support.
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